In the 1980s, a research team led by Parisian scientists identified several unique DNA sequences, or haplotypes, linked to sickle cell anemia in African populations. After casual observations of how ...
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In the 1980s, a research team led by Parisian scientists identified several unique DNA sequences, or haplotypes, linked to sickle cell anemia in African populations. After casual observations of how patients managed this painful blood disorder, the researchers in question postulated that the Senegalese type was less severe. This book traces how this genetic discourse has blotted from view the roles that Senegalese patients and doctors have played in making sickle cell “mild” in a social setting where public health priorities and economic austerity programs have forced people to improvise informal strategies of care. The book shows how geneticists, who were fixated on population differences, never investigated the various modalities of self-care that people developed in this context of biomedical scarcity, and how local doctors, confronted with dire cuts in Senegal's health sector, wittingly accepted the genetic prognosis of better-than-expected health outcomes. Unlike most genetic determinisms that highlight the absoluteness of disease, DNA haplotypes for sickle cell in Senegal did the opposite. As the book demonstrates, they allowed the condition to remain officially invisible, never to materialize as a health priority. At the same time, scientists' attribution of a less severe form of Senegalese sickle cell to isolated DNA sequences closed off other explanations of this population's measured biological success. This book reveals how the notion of an advantageous form of sickle cell in this part of West Africa has defined—and obscured—the nature of this illness in Senegal today.Less

Duana Fullwiley

Published in print: 2011-11-27

In the 1980s, a research team led by Parisian scientists identified several unique DNA sequences, or haplotypes, linked to sickle cell anemia in African populations. After casual observations of how patients managed this painful blood disorder, the researchers in question postulated that the Senegalese type was less severe. This book traces how this genetic discourse has blotted from view the roles that Senegalese patients and doctors have played in making sickle cell “mild” in a social setting where public health priorities and economic austerity programs have forced people to improvise informal strategies of care. The book shows how geneticists, who were fixated on population differences, never investigated the various modalities of self-care that people developed in this context of biomedical scarcity, and how local doctors, confronted with dire cuts in Senegal's health sector, wittingly accepted the genetic prognosis of better-than-expected health outcomes. Unlike most genetic determinisms that highlight the absoluteness of disease, DNA haplotypes for sickle cell in Senegal did the opposite. As the book demonstrates, they allowed the condition to remain officially invisible, never to materialize as a health priority. At the same time, scientists' attribution of a less severe form of Senegalese sickle cell to isolated DNA sequences closed off other explanations of this population's measured biological success. This book reveals how the notion of an advantageous form of sickle cell in this part of West Africa has defined—and obscured—the nature of this illness in Senegal today.

This chapter describes the role of self-silencing in women's experiences of coping with cancer. It discusses various relevant psychosocial factors, including emotional distress, quality of life, and ...
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This chapter describes the role of self-silencing in women's experiences of coping with cancer. It discusses various relevant psychosocial factors, including emotional distress, quality of life, and self-care agency. It provides a general framework for conceptualizing the experiences of those affected by life-threatening illness, and explores specific implications for understanding the emotional and relational issues encountered by women diagnosed with cancer. These issues include dealing with depression, attempting to engage in self-care, and contending with fears of cancer recurrence and possible death. The chapter also provides suggestions for working therapeutically and supportively to encourage positive change for women living with cancer.Less

Facilitating Women's Development through the Illness of Cancer: Depression, Self-Silencing, and Self-Care

Mary Sormanti

Published in print: 2010-03-31

This chapter describes the role of self-silencing in women's experiences of coping with cancer. It discusses various relevant psychosocial factors, including emotional distress, quality of life, and self-care agency. It provides a general framework for conceptualizing the experiences of those affected by life-threatening illness, and explores specific implications for understanding the emotional and relational issues encountered by women diagnosed with cancer. These issues include dealing with depression, attempting to engage in self-care, and contending with fears of cancer recurrence and possible death. The chapter also provides suggestions for working therapeutically and supportively to encourage positive change for women living with cancer.

This chapter examines how women who are in support groups after myocardial heart infarction are silenced by approaches to treatment that are derived solely from men's experiences with heart disease. ...
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This chapter examines how women who are in support groups after myocardial heart infarction are silenced by approaches to treatment that are derived solely from men's experiences with heart disease. It presents evidence of how treatment can address self-silencing in order to facilitate women's positive coping to help them return to health. It discusses the relevance of silencing the self theory in conceptualizing women's experience of cardiovascular disease, particularly in light of the lack of attention given to women's—as opposed to men's—experience of heart disease. Using illustrative case examples, the chapter demonstrates the contradictions between women's needs to focus on their own recovery and to simultaneously meet the needs of those around them. The chapter also describes possible psychosocial approaches for recovery and rehabilitation for women with cardiovascular disease.Less

Silencing the Heart: Women in Treatment for Cardiovascular Disease

Maria I. Medved

Published in print: 2010-03-31

This chapter examines how women who are in support groups after myocardial heart infarction are silenced by approaches to treatment that are derived solely from men's experiences with heart disease. It presents evidence of how treatment can address self-silencing in order to facilitate women's positive coping to help them return to health. It discusses the relevance of silencing the self theory in conceptualizing women's experience of cardiovascular disease, particularly in light of the lack of attention given to women's—as opposed to men's—experience of heart disease. Using illustrative case examples, the chapter demonstrates the contradictions between women's needs to focus on their own recovery and to simultaneously meet the needs of those around them. The chapter also describes possible psychosocial approaches for recovery and rehabilitation for women with cardiovascular disease.

This chapter examines how the hagiographies of friends of God enable manifold readings that enable different forms of attachment to Islamic discourses of ethical self-care and spiritual wayfaring. On ...
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This chapter examines how the hagiographies of friends of God enable manifold readings that enable different forms of attachment to Islamic discourses of ethical self-care and spiritual wayfaring. On the one hand, these readings fully inhabit a mystically inclined Shiʻi tradition featuring proponents and detractors that are both powerful and influential. On the other hand, reading becomes an exercise in a kind of unspoken eclecticism that brings Islamic mysticism under the sign of a universal spirituality through the mediation of the imported sciences of metaphysics. The notion that the marvels of God's friends may be acquired through something other than pious discipline both depends on the Islamic mystical tradition and exceeds it. The chapter compares the search for technical formulas for securing pious self-certainty with other forms of metaphysical experimentation, namely, those that emphasize personal experience, empiricist methods, and scientific models.Less

Hagiographies Unbound

Alireza Doostdar

Published in print: 2018-03-20

This chapter examines how the hagiographies of friends of God enable manifold readings that enable different forms of attachment to Islamic discourses of ethical self-care and spiritual wayfaring. On the one hand, these readings fully inhabit a mystically inclined Shiʻi tradition featuring proponents and detractors that are both powerful and influential. On the other hand, reading becomes an exercise in a kind of unspoken eclecticism that brings Islamic mysticism under the sign of a universal spirituality through the mediation of the imported sciences of metaphysics. The notion that the marvels of God's friends may be acquired through something other than pious discipline both depends on the Islamic mystical tradition and exceeds it. The chapter compares the search for technical formulas for securing pious self-certainty with other forms of metaphysical experimentation, namely, those that emphasize personal experience, empiricist methods, and scientific models.

Is emotion a form of concern with things as they affect my well-being (and thus instrumental in this sense)? Many philosophers think it is, and emotion does have ways of becoming markedly ...
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Is emotion a form of concern with things as they affect my well-being (and thus instrumental in this sense)? Many philosophers think it is, and emotion does have ways of becoming markedly self-centered. This happens when a person’s emotion comes itself to matter to him because it is his and the rest of the world because of how it impinges on his emotions. With this narcissistic focus, one’s emotions then attract further, second-order emotions. But narcissistic emotion is disordered: only some emotions are properly emotions of self-care, and for others to be given this form is isolating and inimical to emotional depth.Less

Narcissism in Emotion

David Pugmire

Published in print: 2005-04-21

Is emotion a form of concern with things as they affect my well-being (and thus instrumental in this sense)? Many philosophers think it is, and emotion does have ways of becoming markedly self-centered. This happens when a person’s emotion comes itself to matter to him because it is his and the rest of the world because of how it impinges on his emotions. With this narcissistic focus, one’s emotions then attract further, second-order emotions. But narcissistic emotion is disordered: only some emotions are properly emotions of self-care, and for others to be given this form is isolating and inimical to emotional depth.

The central thesis of this book is that Michel Foucault’s account of power does not foreclose the possibility of ethics; on the contrary, it provides a framework within which ethics becomes possible. ...
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The central thesis of this book is that Michel Foucault’s account of power does not foreclose the possibility of ethics; on the contrary, it provides a framework within which ethics becomes possible. Tracing the evolution of Foucault’s analysis of power from his early articulations of disciplinary power to his theorizations of biopower and governmentality, the book shows how Foucault’s ethical project emerged through two interwoven trajectories: analysis of classical practices of the care of the self, and engaged practice in and reflection upon the limits of sexuality and the development of friendship in gay communities. These strands of experience and inquiry allowed Foucault to develop contrasting yet interwoven aspects of his ethics; they also underscored how ethical practice emerges within and from contexts of power relations. The gay community’s response to AIDS and its parallels with the feminist ethics of care serve to illustrate the resources of a Foucauldian ethic—a fundamentally critical attitude, with substantive (but revisable) values and norms grounded in a practice of freedom.Less

Foucault's Critical Ethics

Richard A. Lynch

Published in print: 2016-09-05

The central thesis of this book is that Michel Foucault’s account of power does not foreclose the possibility of ethics; on the contrary, it provides a framework within which ethics becomes possible. Tracing the evolution of Foucault’s analysis of power from his early articulations of disciplinary power to his theorizations of biopower and governmentality, the book shows how Foucault’s ethical project emerged through two interwoven trajectories: analysis of classical practices of the care of the self, and engaged practice in and reflection upon the limits of sexuality and the development of friendship in gay communities. These strands of experience and inquiry allowed Foucault to develop contrasting yet interwoven aspects of his ethics; they also underscored how ethical practice emerges within and from contexts of power relations. The gay community’s response to AIDS and its parallels with the feminist ethics of care serve to illustrate the resources of a Foucauldian ethic—a fundamentally critical attitude, with substantive (but revisable) values and norms grounded in a practice of freedom.

This chapter discusses the importance of compassion and service in providing spiritual care in the palliative care sector, describing the cases of 85-year-old Miles, Estelle, and Itny. It also ...
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This chapter discusses the importance of compassion and service in providing spiritual care in the palliative care sector, describing the cases of 85-year-old Miles, Estelle, and Itny. It also outlines some of the elements of spiritual care, which include compassionate presence and love for another, reverence for mystery, healing as partnership, and self-care of the caregiver.Less

Spiritual Care: Compassion and Service to Others

Christina M. Puchalski

Published in print: 2006-07-20

This chapter discusses the importance of compassion and service in providing spiritual care in the palliative care sector, describing the cases of 85-year-old Miles, Estelle, and Itny. It also outlines some of the elements of spiritual care, which include compassionate presence and love for another, reverence for mystery, healing as partnership, and self-care of the caregiver.

How does someone become a psychotherapist? What sort of education and training, life experiences, and professional experiences are necessary to become a competent psychotherapist? Do certain ...
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How does someone become a psychotherapist? What sort of education and training, life experiences, and professional experiences are necessary to become a competent psychotherapist? Do certain childhood experiences, or some combination of genetic endowment and personality traits, equip one to become a more effective and successful psychotherapist? Is there a common path that psychotherapists follow in their development? This volume explores in depth the experiences that therapists have over the course of their lifetimes, both personal and professional, that contribute to their professional identities as practicing psychotherapists. The process of becoming a psychotherapist in the context of today’s rapidly changing healthcare environment is deconstructed. Each of the essential building blocks is addressed in a series of chapters authored by acknowledged experts in the field who draw upon their experience and expertise, as well as their personal reflections. Wherever possible, they incorporate findings from relevant empirical research into their chapters, and highlight ethical, cultural and diversity issues. Among the matters considered is how the training of mental health professionals should be affected by the increased recognition of the importance of the therapist’s person to treatment outcome; how to integrate our understanding of the personal and professional experiences that developing psychotherapists have with the formal training they receive; and how the shifting cultural context, with its emphasis on cost-containment, efficacy and accountability for treatment interventions, shapes the demands and challenges facing psychotherapists today. The concluding chapter presents a comprehensive five-stage model for psychotherapist development to shed light upon how these components are effectively organized and integrated, and to address the current controversies that surround what constitutes the optimal set of experiences for the developing psychotherapist. The challenges facing practitioners in the contemporary healthcare environment are considered in terms of their implications for psychotherapist selection, education, supervision, practice, self-care and continued professional growth, and with an eye toward delineating what mitigates for and against good treatment outcomes.Less

On Becoming a Psychotherapist : The Personal and Professional Journey

Published in print: 2010-12-31

How does someone become a psychotherapist? What sort of education and training, life experiences, and professional experiences are necessary to become a competent psychotherapist? Do certain childhood experiences, or some combination of genetic endowment and personality traits, equip one to become a more effective and successful psychotherapist? Is there a common path that psychotherapists follow in their development? This volume explores in depth the experiences that therapists have over the course of their lifetimes, both personal and professional, that contribute to their professional identities as practicing psychotherapists. The process of becoming a psychotherapist in the context of today’s rapidly changing healthcare environment is deconstructed. Each of the essential building blocks is addressed in a series of chapters authored by acknowledged experts in the field who draw upon their experience and expertise, as well as their personal reflections. Wherever possible, they incorporate findings from relevant empirical research into their chapters, and highlight ethical, cultural and diversity issues. Among the matters considered is how the training of mental health professionals should be affected by the increased recognition of the importance of the therapist’s person to treatment outcome; how to integrate our understanding of the personal and professional experiences that developing psychotherapists have with the formal training they receive; and how the shifting cultural context, with its emphasis on cost-containment, efficacy and accountability for treatment interventions, shapes the demands and challenges facing psychotherapists today. The concluding chapter presents a comprehensive five-stage model for psychotherapist development to shed light upon how these components are effectively organized and integrated, and to address the current controversies that surround what constitutes the optimal set of experiences for the developing psychotherapist. The challenges facing practitioners in the contemporary healthcare environment are considered in terms of their implications for psychotherapist selection, education, supervision, practice, self-care and continued professional growth, and with an eye toward delineating what mitigates for and against good treatment outcomes.

Harriet Beecher Stowe's religious conversion of 1843 was paralleled in 1846 by a secular conversion to the water cure. Both were informed by the millennial hope of a perfect world, ...
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Harriet Beecher Stowe's religious conversion of 1843 was paralleled in 1846 by a secular conversion to the water cure. Both were informed by the millennial hope of a perfect world, and both placed a baptism and a crisis at the heart of the cure. “Wash and Be Healed,” proclaimed the banner of the Water-Cure Journal, unabashedly appealing to millennial hopes. Hydropathy promised to do for the body what religious conversion had done for the soul. Appealing to the reformist striving of the age, hydropathy's goals were framed in specific, this worldly terms, that siphoned off religious energies into secular channels; in this respect the water cure was a harbinger of late-Victorian culture. Hydropathy taught that hygienic living was the best prevention of illness, and that through self-care one could enjoy good health and freedom from drugs and doctors. Hydropathy had strong links with homeopathy, which advocated the use of miniscule doses of medicine.Less

The Water Cure: 1846–1848

Joan D. Hedrick

Published in print: 1995-07-27

Harriet Beecher Stowe's religious conversion of 1843 was paralleled in 1846 by a secular conversion to the water cure. Both were informed by the millennial hope of a perfect world, and both placed a baptism and a crisis at the heart of the cure. “Wash and Be Healed,” proclaimed the banner of the Water-Cure Journal, unabashedly appealing to millennial hopes. Hydropathy promised to do for the body what religious conversion had done for the soul. Appealing to the reformist striving of the age, hydropathy's goals were framed in specific, this worldly terms, that siphoned off religious energies into secular channels; in this respect the water cure was a harbinger of late-Victorian culture. Hydropathy taught that hygienic living was the best prevention of illness, and that through self-care one could enjoy good health and freedom from drugs and doctors. Hydropathy had strong links with homeopathy, which advocated the use of miniscule doses of medicine.

Caring for ourselves informs of our species activity. Over recent years the concept of ‘self-care’ has been mobilized by policy makers and governments in the deepening of neoliberal objectives to ...
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Caring for ourselves informs of our species activity. Over recent years the concept of ‘self-care’ has been mobilized by policy makers and governments in the deepening of neoliberal objectives to dismantle public welfare resources and shift responsibility for care onto individual citizens. Yet ideas about self-care have a longer and wider history as part of collective struggles - for recognition of the experiences of disabled people, of women’s health movements challenging medical hierarchies and in contexts of community-led peer support and self-help groups. This chapter problematizes the concept of self-care and the implications of its co-option into neo-liberal objectives of enforcing individual responsibilities. It argues that an alternative articulation of self-care based in care ethics is vital if to secure government responsibility for the care and welfare of citizens.Less

Caring for ourselves? Self-care and neoliberalism

Lizzie Ward

Published in print: 2015-10-28

Caring for ourselves informs of our species activity. Over recent years the concept of ‘self-care’ has been mobilized by policy makers and governments in the deepening of neoliberal objectives to dismantle public welfare resources and shift responsibility for care onto individual citizens. Yet ideas about self-care have a longer and wider history as part of collective struggles - for recognition of the experiences of disabled people, of women’s health movements challenging medical hierarchies and in contexts of community-led peer support and self-help groups. This chapter problematizes the concept of self-care and the implications of its co-option into neo-liberal objectives of enforcing individual responsibilities. It argues that an alternative articulation of self-care based in care ethics is vital if to secure government responsibility for the care and welfare of citizens.

This chapter proposes a generic, comprehensive, phase-specific schema or framework that can be used to think about psychotherapist development. To accomplish this task, it attempts to integrate ...
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This chapter proposes a generic, comprehensive, phase-specific schema or framework that can be used to think about psychotherapist development. To accomplish this task, it attempts to integrate information and insight from four separate sources: (1) specific ideas advanced by the contributing authors; (2) understanding of the available literature in the field; (3) ideas about psychotherapist development; and (4) a view of the current context within which psychotherapists develop and practice their craft. Following this presentation, the remainder of the chapter is devoted to a series of recommendations regarding: (1) the selection of candidates for psychotherapist training; (2) the optimal content for training programs in terms of (a) didactic preparation, and (b) the nature of clinical experiences; (3) therapist self-care; and (4) continued professional growth.Less

Conclusions: A Phase-Specific Model for Psychotherapist Development

Robert H. KleinHarold S. BernardVictor L. Schermer

Published in print: 2010-12-31

This chapter proposes a generic, comprehensive, phase-specific schema or framework that can be used to think about psychotherapist development. To accomplish this task, it attempts to integrate information and insight from four separate sources: (1) specific ideas advanced by the contributing authors; (2) understanding of the available literature in the field; (3) ideas about psychotherapist development; and (4) a view of the current context within which psychotherapists develop and practice their craft. Following this presentation, the remainder of the chapter is devoted to a series of recommendations regarding: (1) the selection of candidates for psychotherapist training; (2) the optimal content for training programs in terms of (a) didactic preparation, and (b) the nature of clinical experiences; (3) therapist self-care; and (4) continued professional growth.

Kathryn Shively Meier examines Union and Confederate soldiers in her essay. The battle of Cold Harbor famously has been described as “not war” but “murder.” Veterans and historians alike have ...
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Kathryn Shively Meier examines Union and Confederate soldiers in her essay. The battle of Cold Harbor famously has been described as “not war” but “murder.” Veterans and historians alike have characterized the battle as exceptionally violent, bloody, and crippling to soldier morale and willingness to fight. Meier departs strikingly from this conception of Cold Harbor while placing the battle within the wider scope of operations in May and early June. Despite the relentless pace of the campaign and the high casualty figures, she explains, the vast majority of volunteers endured and responded to circumstances ranging from lack of provisions and harsh summer heat to endless hours spent in the trenches by resorting to self-care strategies. Adapting techniques they had employed in previous campaigns, such as stealing away for a bath in a nearby river, volunteers remained functioning soldiers during and after Cold Harbor.Less

I Told Him to Go On : Enduring Cold Harbor

Kathryn Shively Meier

Published in print: 2015-09-25

Kathryn Shively Meier examines Union and Confederate soldiers in her essay. The battle of Cold Harbor famously has been described as “not war” but “murder.” Veterans and historians alike have characterized the battle as exceptionally violent, bloody, and crippling to soldier morale and willingness to fight. Meier departs strikingly from this conception of Cold Harbor while placing the battle within the wider scope of operations in May and early June. Despite the relentless pace of the campaign and the high casualty figures, she explains, the vast majority of volunteers endured and responded to circumstances ranging from lack of provisions and harsh summer heat to endless hours spent in the trenches by resorting to self-care strategies. Adapting techniques they had employed in previous campaigns, such as stealing away for a bath in a nearby river, volunteers remained functioning soldiers during and after Cold Harbor.

In order to supply adequate and appropriate services for older persons, it is useful to identify their needs. This chapter introduces the concept of care dependency, which is defined as the need to ...
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In order to supply adequate and appropriate services for older persons, it is useful to identify their needs. This chapter introduces the concept of care dependency, which is defined as the need to receive support in order to compensate for a self-care deficit. Care dependency can be determined only by subjective assessments. For this reason, perceived needs are likely to be related to care-seeking attitudes, although they are not identical. Feeling a need for support and liking to receive it are two distinct phenomena. The assessment of care dependency provides an idea about the amount of care needed to compensate for deficits and limitations, whereas the assessment of care-seeking attitudes informs about the kind of support that is accepted by the older persons.Less

Care Needs and Care Dependency

Thomas Boggatz

Published in print: 2011-11-15

In order to supply adequate and appropriate services for older persons, it is useful to identify their needs. This chapter introduces the concept of care dependency, which is defined as the need to receive support in order to compensate for a self-care deficit. Care dependency can be determined only by subjective assessments. For this reason, perceived needs are likely to be related to care-seeking attitudes, although they are not identical. Feeling a need for support and liking to receive it are two distinct phenomena. The assessment of care dependency provides an idea about the amount of care needed to compensate for deficits and limitations, whereas the assessment of care-seeking attitudes informs about the kind of support that is accepted by the older persons.

Care dependency is a perceived need for help with regard to self-care activities. The Care Dependency Scale (CDS) was designed to assess these needs. This chapter explores care needs among older ...
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Care dependency is a perceived need for help with regard to self-care activities. The Care Dependency Scale (CDS) was designed to assess these needs. This chapter explores care needs among older Egyptians as measured by the Arabic CDS. It describes the prevalence of the different aspects of care dependency in order to determine which kind of support is most needed. The result is different for care service recipients and non-care-service recipients. As care service recipients are composed of home care service recipients and nursing-home residents, a further differentiation provides an idea about the prevalence and type of care problems in each kind of care facility. An assessment of unmet needs is useful as an indicator of the quality of care, since it shows which types of facilities satisfy most of the existing needs.Less

Care Dependency and Unmet Needs: Prevalence and Contributing Factors

Thomas Boggatz

Published in print: 2011-11-15

Care dependency is a perceived need for help with regard to self-care activities. The Care Dependency Scale (CDS) was designed to assess these needs. This chapter explores care needs among older Egyptians as measured by the Arabic CDS. It describes the prevalence of the different aspects of care dependency in order to determine which kind of support is most needed. The result is different for care service recipients and non-care-service recipients. As care service recipients are composed of home care service recipients and nursing-home residents, a further differentiation provides an idea about the prevalence and type of care problems in each kind of care facility. An assessment of unmet needs is useful as an indicator of the quality of care, since it shows which types of facilities satisfy most of the existing needs.

To find a coherent account of normal and abnormal psychology from within Burton’s religious presuppositions and humoral explanations requires selection and interpretation. This reading highlights ...
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To find a coherent account of normal and abnormal psychology from within Burton’s religious presuppositions and humoral explanations requires selection and interpretation. This reading highlights Burton’s stress on the role of the imagination in inciting and averting melancholy; his emphasis on daily habits of thought in engendering, as well as avoiding, severe disorder; the multidirectional feedback loops linking feeling and thought in his particular version of embodied interactionism; and the centrality of symptoms, natural history and habituation in his conception of disease. Much of the Anatomy comes from classical, medieval, and renaissance writing, yet it yields an account that concurs well with present-day cognitivism. Although with its signature fears and sadnesses seventeenth-century melancholy bears only a loose relationship to present-day mood disorders such as depression and anxiety, on this reading, the Anatomy anticipates important present-day findings and hypotheses, including psychiatry’s network models of depression; the part played by affective states and imagination (or simulation) in all cognition, and links between “melancholising” or rumination, and affective disorder. The Anatomy of Melancholy offers a host of recommendations for averting, and remedying, melancholy as disease, and its emphasis on early prevention, eclectic, multifactorial treatments, and consistent self-care are traceable to its underlying cognitive architecture and disease conception. Averted early through adherence to the regimen of Galenic medicine with its six “nonnaturals” that together regulate the passions, it suggests, severe, intractable melancholy can mostly be avoided. It a progressive disorder engendered by neglected cognitive and behavioral habits, so prevention largely lies in attentive self-care—a conception, and conclusion, with likely implications for psychiatry today.Less

Melancholic Habits : Burton's Anatomy & the Mind Sciences

Jennifer Radden

Published in print: 2017-01-26

To find a coherent account of normal and abnormal psychology from within Burton’s religious presuppositions and humoral explanations requires selection and interpretation. This reading highlights Burton’s stress on the role of the imagination in inciting and averting melancholy; his emphasis on daily habits of thought in engendering, as well as avoiding, severe disorder; the multidirectional feedback loops linking feeling and thought in his particular version of embodied interactionism; and the centrality of symptoms, natural history and habituation in his conception of disease. Much of the Anatomy comes from classical, medieval, and renaissance writing, yet it yields an account that concurs well with present-day cognitivism. Although with its signature fears and sadnesses seventeenth-century melancholy bears only a loose relationship to present-day mood disorders such as depression and anxiety, on this reading, the Anatomy anticipates important present-day findings and hypotheses, including psychiatry’s network models of depression; the part played by affective states and imagination (or simulation) in all cognition, and links between “melancholising” or rumination, and affective disorder. The Anatomy of Melancholy offers a host of recommendations for averting, and remedying, melancholy as disease, and its emphasis on early prevention, eclectic, multifactorial treatments, and consistent self-care are traceable to its underlying cognitive architecture and disease conception. Averted early through adherence to the regimen of Galenic medicine with its six “nonnaturals” that together regulate the passions, it suggests, severe, intractable melancholy can mostly be avoided. It a progressive disorder engendered by neglected cognitive and behavioral habits, so prevention largely lies in attentive self-care—a conception, and conclusion, with likely implications for psychiatry today.

Doctors are often accused of playing god because they must make life-and-death decisions. Professional ethics and standards of care require physicians to keep secrets; they must live with the ...
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Doctors are often accused of playing god because they must make life-and-death decisions. Professional ethics and standards of care require physicians to keep secrets; they must live with the memories of split-second decisions often made by instinct; and they can endure the multitude of patients’ pain and suffering every day, day after day. Added to patient-related pressures are the pressures and politics of the House of Medicine, along with a constant drumbeat to train more physicians due to the worldwide shortage of physicians. Yet physicians are human beings who feel pain like everyone else. These demands, and the associated day-to-day challenges of physicianship, can take their toll on doctors, leading to mental health problems, reduced job satisfaction and productivity, and eventually lowered retention. Stress can lead to poor communication between doctors and their colleagues and between doctors and their patients. In the long run, for doctors to avoid harming patients, they must first do no self-harm. First Do No Self-Harm, edited by three medical and mental health educators, offers a clarion call for the improved medical and mental health of physicians across the education continuum by posing and answering five fundamental questions: (1) What are the sources of stress? (2) What are the stress-related consequences for those who work and seek treatment in the House of Medicine? (3) How do they cope with their stressful jobs? (4) What strategies can be used to promote resilience among physicians? (5) How can medical and mental health educators acquire the skills and wisdom to tackle the culture of stoicism and emotional silence in the House of Medicine that encourages physicians’ self-harm?Less

First Do No Self Harm : Understanding and Promoting Physician Stress Resilience

Charles FigleyPeter HuggardCharlotte Rees

Published in print: 2013-09-16

Doctors are often accused of playing god because they must make life-and-death decisions. Professional ethics and standards of care require physicians to keep secrets; they must live with the memories of split-second decisions often made by instinct; and they can endure the multitude of patients’ pain and suffering every day, day after day. Added to patient-related pressures are the pressures and politics of the House of Medicine, along with a constant drumbeat to train more physicians due to the worldwide shortage of physicians. Yet physicians are human beings who feel pain like everyone else. These demands, and the associated day-to-day challenges of physicianship, can take their toll on doctors, leading to mental health problems, reduced job satisfaction and productivity, and eventually lowered retention. Stress can lead to poor communication between doctors and their colleagues and between doctors and their patients. In the long run, for doctors to avoid harming patients, they must first do no self-harm. First Do No Self-Harm, edited by three medical and mental health educators, offers a clarion call for the improved medical and mental health of physicians across the education continuum by posing and answering five fundamental questions: (1) What are the sources of stress? (2) What are the stress-related consequences for those who work and seek treatment in the House of Medicine? (3) How do they cope with their stressful jobs? (4) What strategies can be used to promote resilience among physicians? (5) How can medical and mental health educators acquire the skills and wisdom to tackle the culture of stoicism and emotional silence in the House of Medicine that encourages physicians’ self-harm?

This chapter explores how adult children of Korean immigrants in their twenties, thirties, and forties are navigating and remembering their parents' traumatic, war-inflected pre-migration histories. ...
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This chapter explores how adult children of Korean immigrants in their twenties, thirties, and forties are navigating and remembering their parents' traumatic, war-inflected pre-migration histories. In particular, it considers how immigrant children are giving back for their parents' challenges and sacrifices while also making choices for themselves with respect to career, love, and marriage. It also shows how the immigration experience is connected to American-born and/or American-raised adult children to the Korean War experiences of their immigrant parents. Finally, it examines how adult children recognize their own feelings around obligations and duty to their parents as they reflect on their own dreams, passions, and needs for self-care.Less

Giving Back

Grace J. YooBarbara W. Kim

Published in print: 2014-06-20

This chapter explores how adult children of Korean immigrants in their twenties, thirties, and forties are navigating and remembering their parents' traumatic, war-inflected pre-migration histories. In particular, it considers how immigrant children are giving back for their parents' challenges and sacrifices while also making choices for themselves with respect to career, love, and marriage. It also shows how the immigration experience is connected to American-born and/or American-raised adult children to the Korean War experiences of their immigrant parents. Finally, it examines how adult children recognize their own feelings around obligations and duty to their parents as they reflect on their own dreams, passions, and needs for self-care.

What might bringing tenderness into the world look like? Student activism and willingness to explore historical memory from their own families often illuminate lived examples of tenderness. The life ...
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What might bringing tenderness into the world look like? Student activism and willingness to explore historical memory from their own families often illuminate lived examples of tenderness. The life changing experience Thompson had as a first responder during the refugee crisis in Lesvos, Greece (2015-2016), as I met Syrian, Afghan, Palestinian, and Pakistani families coming on rafts from Turkey, taught her much about tenderness as a quality of being with each other. Refugee families modeled tenderness for her as they risked their lives to save their lives.
While militarism, colonialism, racism, and patriarchy remain structural impediments to tenderness, as teachers we find ourselves seeking renewal, knowing that, as Angela Davis has written, “without deep, abiding practices of self care, there can be no radical social transformation.” So this is where we start, rethinking our relationship to our bodies, grading, office hours, faculty meetings, and methods of evaluation. We want to send students off ready to do justice work. Such work may start with examining what the Turkish poet Nazim Hikmet has called the “jewel at the left side of your chest.” Our own jewels in this lifetime.
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Our Bodies in the World

Becky Thompson

Published in print: 2017-08-01

What might bringing tenderness into the world look like? Student activism and willingness to explore historical memory from their own families often illuminate lived examples of tenderness. The life changing experience Thompson had as a first responder during the refugee crisis in Lesvos, Greece (2015-2016), as I met Syrian, Afghan, Palestinian, and Pakistani families coming on rafts from Turkey, taught her much about tenderness as a quality of being with each other. Refugee families modeled tenderness for her as they risked their lives to save their lives.
While militarism, colonialism, racism, and patriarchy remain structural impediments to tenderness, as teachers we find ourselves seeking renewal, knowing that, as Angela Davis has written, “without deep, abiding practices of self care, there can be no radical social transformation.” So this is where we start, rethinking our relationship to our bodies, grading, office hours, faculty meetings, and methods of evaluation. We want to send students off ready to do justice work. Such work may start with examining what the Turkish poet Nazim Hikmet has called the “jewel at the left side of your chest.” Our own jewels in this lifetime.

In this chapter, the author talks about the kind of caring provided by nurses to patients in the intensive care unit (ICU). He begins by discussing how nursing as a profession has tried to separate ...
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In this chapter, the author talks about the kind of caring provided by nurses to patients in the intensive care unit (ICU). He begins by discussing how nursing as a profession has tried to separate itself from medicine, citing the self-care theory advanced by Dorothea Orem, and goes on to consider the philosophy of caring developed by Jean Watson in the 1970s. He also explains empathy and caring as the cornerstones of nursing and Watson's identification of ten “carative” factors: attentive listening, comforting, honesty, patience, responsibility, providing information, touch, sensitivity, respect, and calling the patient by name. The author concludes by commenting on the question of survival from critical illness and suggests that nurses treat patients medically in a different way, and not in a way different from that of medicine.Less

Caring

James Kelly

Published in print: 2013-02-28

In this chapter, the author talks about the kind of caring provided by nurses to patients in the intensive care unit (ICU). He begins by discussing how nursing as a profession has tried to separate itself from medicine, citing the self-care theory advanced by Dorothea Orem, and goes on to consider the philosophy of caring developed by Jean Watson in the 1970s. He also explains empathy and caring as the cornerstones of nursing and Watson's identification of ten “carative” factors: attentive listening, comforting, honesty, patience, responsibility, providing information, touch, sensitivity, respect, and calling the patient by name. The author concludes by commenting on the question of survival from critical illness and suggests that nurses treat patients medically in a different way, and not in a way different from that of medicine.

In this chapter we reflect on the role of physicians, the pressures they endure, potential negative outcomes, and a promising treatment for encouraging self-awareness and self-care. We conceptualize ...
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In this chapter we reflect on the role of physicians, the pressures they endure, potential negative outcomes, and a promising treatment for encouraging self-awareness and self-care. We conceptualize this process of exhaustion as compassion fatigue, which incorporates burnout and the silencing response, which may lead to negative behaviors such as substance abuse and even suicidality. We propose and discuss a new term, “the overcoper” as an identity that many is be emphasized. The Accelerated Recovery Program for treatment of physicians and other health care professionals who are experiencing compassion fatigue is also described.Less

Overcopers : Medical Doctor Vulnerability to Compassion Fatigue

Anna BaranowskyDouglas Schmidt

Published in print: 2013-09-16

In this chapter we reflect on the role of physicians, the pressures they endure, potential negative outcomes, and a promising treatment for encouraging self-awareness and self-care. We conceptualize this process of exhaustion as compassion fatigue, which incorporates burnout and the silencing response, which may lead to negative behaviors such as substance abuse and even suicidality. We propose and discuss a new term, “the overcoper” as an identity that many is be emphasized. The Accelerated Recovery Program for treatment of physicians and other health care professionals who are experiencing compassion fatigue is also described.